Jäger W, Sauerbrei W
Department of Obstetrics and Gynecology, University of Erlangen, Germany.
Breast Cancer Res Treat. 1995 Jun;34(3):279-87. doi: 10.1007/BF00689719.
In 1989 it was suggested that the timing of surgery during follicular or corpus luteum phase of the menstrual cycle could substantially influence the survival time in premenopausal breast-cancer patients [1]. Several researchers analysed their data, but in general they could not confirm this observation. Nevertheless, two other reports in that series found some influence of the time of surgery during menstrual cycle on prognosis, although, they suggested different time periods as favourable [8, 9].
The purpose of this study was to investigate the effect of timing of surgery in a study population which was much larger than the previous studies.
All premenopausal patients with primary breast cancer who had been operated at one clinic between 1st of January 1980 and 31st of December 1990 were considered eligible for the study. Based on the day of surgery during the menstrual cycle all patients were grouped according to three proposed categories and to an additional one which consisted of the favourable days from the three proposed categories. We investigated the effects of several prognostic factors and of the timing of surgery on three endpoints: recurrence free survival, distant disease free survival, and overall survival.
The traditional prognostic factors had effects in agreement with the literature. Of the different categories for timing of surgery none had a significant influence; the strongest in univariate analysis had a p-value of 0.10 and the trend was in the opposite direction to the one proposed in the literature. These results did not change in multivariate analysis with the Cox model.
Timing of surgery does not have an important effect on the prognosis of breast cancer patients. Incorporating other results from the literature, we conclude that it has at most a weak effect.
At present there is no need to incorporate the day of menstrual cycle in the planning of surgery for premenopausal breast cancer patients.
1989年有人提出，绝经前乳腺癌患者在月经周期的卵泡期或黄体期进行手术的时间可能会显著影响其生存时间[1]。几位研究人员分析了他们的数据，但总体而言他们无法证实这一观察结果。然而，该系列中的另外两篇报告发现月经周期中手术时间对预后有一些影响，尽管他们提出的有利时间段不同[8,9]。
本研究的目的是在一个比以往研究大得多的研究人群中调查手术时间的影响。
所有在1980年1月1日至1990年12月31日期间在一家诊所接受手术的绝经前原发性乳腺癌患者均被认为符合该研究的条件。根据月经周期中的手术日，所有患者被分为三个提议的类别以及一个由这三个提议类别中的有利天数组成的额外类别。我们研究了几个预后因素和手术时间对三个终点的影响：无复发生存率、无远处疾病生存率和总生存率。
传统的预后因素的影响与文献一致。在手术时间的不同类别中，没有一个有显著影响；单因素分析中最强的p值为0.10，且趋势与文献中提出的相反。在使用Cox模型的多因素分析中，这些结果没有改变。
手术时间对乳腺癌患者的预后没有重要影响。结合文献中的其他结果，我们得出结论，它至多有微弱的影响。
目前，在为绝经前乳腺癌患者制定手术计划时，无需考虑月经周期的日期。
